Apology to my surgeon

Even the best surgeon might not be able to explain exactly what she did and why. But that doesn’t make her less of a surgeon.

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So I saw the doctor today. Doctors, actually. The surgeon and the medical oncologist (chemo guy). My daughter-in-law was with me to be my backup ears, etc. and we both still couldn’t understand the surgeon’s explanation of how her surgery and the result was good, even though she didn’t get clean margins on the tumor.

Finally, when we talked to the MO, we understood, and now I almost feel I owe the surgeon an apology. True, the tumor’s bottom border was not clean, but that’s because it was sitting on the bone. There was no more tissue she could have removed; she was scraping bone. I thought she’d been saying she couldn’t take any more because she’d be cutting into the muscle. In fact, the MO explained, she did remove some muscle (no ill effect that I’ve noticed). It was the bone that stopped her.

Now whatever cancer cells are left in the area, including the lymph nodes behind the chest wall, will be zapped with chemo and radiation. And less chemo than I expected. Only 4 treatments, 3 weeks apart.

The oncologist also had a pathology report that I hadn’t seen yet that said the HER-2/neu is negative, meaning no cardiotoxic drugs need to be used. (Hurray!) Because the first report said “equivocal” instead of negative, he’s going to be talking to several more pathologists to double- and triple-check everything, but right now it appears he’ll use Taxotere (docetaxel) and Cytoxan (cyclophosphamide) — commonly referred to as the TC regimen.

Chemo probably won’t start for another 10 days to 2 weeks. First I’ll need to get a baseline PET/CT scan (which will show exactly where any remaining cancer cells are) and an echocardiogram (to make sure my heart can take the treatment). Meanwhile, the incision can continue to heal.

So I’m feeling pretty good this evening. Not to mention, I asked the oncologist if there would be any problem getting more Ativan if I needed it and he assured me I could have all I wanted for the duration. He figures cancer patients have enough anxiety without worrying about whether their anxiety meds are going to be cut off.

9 thoughts on “Apology to my surgeon”

  1. I’m following your progress with interest, PT. Your description led me to read up on the combined PT/CAT scan process; I hadn’t known the two types were now combined, but it makes complete sense. Not clear to me from the description is how effective the resolution of the images is in defining any metastasis.

    Clearly, you are getting top-notch technology here. Good. 🙂

    1. If you look up some of the images on Google, you can see how anything cancerous shows up as distinct red or yellow spots on the images. I think it has to do with the fact that cancer cells are growing much faster than normal cells and absorb more of the dye. PET scans are 3-D color images, something no other scanning technology does. Combining them with CT imaging does something to enhance the images. I don’t entirely understand all that.

      Here’s a good article that explains it and has several good images with it: Metabolic Imaging: How PET Scans Are Changing Oncology. And that was 8 years ago.

"You don’t have to say everything to say something." ~Beth Moore

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